• 한국산학기술학회논문지
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• 제10권9호
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• pp.2485-2491
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• 2009

2007년 4월 1일부터 5월 31일까지 2개월 동안 1개 광역도 1개 도농복합도시 지역의 노인요양시설 5곳을 대상으로 실내 외의 공기 중 바이오에어로졸 조사하기 위해 관성충돌 채취법을 적용한 미생물 채취기인 air $IDEAL^{TM}$(Biomerieux)를 이용하여 면양혈액한천배지와 Sabouraud Dextrose Ager를 사용하여 채취하여 배양하였다. 배양하여 분리 동정한 결과 다음과 같은 결과를 얻었다. 1. 각 시설별 전체 미생물의 분리는 300 L 실내에서 S 요양원이 263 cfu/$m^3$로 가장 많았고, U 요양원이 123 cfu/$m^3$로 가장 낮은 수가 분리되었다. 2. 실내에서 300 L를 채취한 배지에서 분리된 세균의 수는 기타 동정되지 않거나 비병원성 그람양성구균이 321개로 가장 많이 분리되었으며, 기타 그람양성구균의 대부분은 CNS(Coagulase Negative Staphylococcus)이었다. 3. 실내에서 300 L를 채취한 배지에서 분리된 진균의 수는 Aspergillus spp. 가 66개로 가장 많이 분리되었으며, 다음으로 Mucor spp. 62개, Penicillium spp. 53개, Alternaria spp. 50개, 기타 동정되지 않거나 비병원성 진균들이 42개의 순으로 분리되었다. 4. 실내 외의 오염비율은 실외보다는 실내에서 모두 평균 집락수가 많았으며, 300 L와 500 L의 공기량의 차이를 둔 조사에서는 공기량이 많을수록 양적으로는 많은 세균이 검출되었지만 균종으로는 큰 변화가 없었다.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.179-194
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• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• 문화기술의 융합
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• 제8권2호
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• pp.59-67
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• 2022

본 연구는 고령자의 적극적인 활동을 유도하고 치유적 기능 및 사회적 활동을 이끌어낼 수 있도록 가드닝 프로그램을 진행한 후, 실시 전후의 결과를 관찰함으로써 가드닝 프로그램에 의한 효과를 정량적으로 파악하는 것이 주목적이다. 연구의 목적을 달성하기 위하여 노인요양시설 2곳에서 노인20명을 대상으로 30회의 가드닝 프로그램을 실시한 결과, 우울에 대한 척도는 실습위주의 프로그램으로 개선효과가 나타났으며, 가드닝 프로그램에 의하여 노인들에게 활력을 주는 것으로 파악되었다. 또한, 가드닝 프로그램에 의해 삶의질이 높아진 것으로 파악되었으며, 뇌의 활성화에 도움이 되는 것으로 파악되었다.

• 디지털융복합연구
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• 제20권5호
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• pp.695-702
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• 2022

본 연구는 노인 일자리에 대한 인식 개선을 위한 실마리를 제시할 목적으로 시행되었으며, 최종 연구대상은 110명 이다. 연구방법은 student t-test, ⲭ²-test, one-way ANOVA(Scheffe)를 실시하였다. 연구결과는 다음과 같다. 연소노인(65-74세)이 노인 일자리 사업에 대한 인식, 경제 상태가 유의하게 높았으며, 공공형 일자리 인식은 기혼, 종교가 있을 때, 월소득이 400만원 초과일 때, 사회서비스형은 기혼, 종교가 있을 때, 민간형은 월소득이 400만원 초과로 나타났다(p<0.05). 공공형 직종 에서는 '주정차 질서 계도 봉사'가, 사회서비스형 직종 중에서는 '노인 관련 시설지원'이, 민간분야 직종에서는 '패스트푸드원, 주방, 식당 보조원, 음식배달서비스 종사자'에 대한 선호도가 가장 높게 나타났다. 결론적으로 연령이 증가함에 따라 낮아지는 노인 일자리 정책에 대한 인식을 향상 시키기 위해 노인 일자리 인식 개선 교육 프로그램이 필요하다. 추후 노인연령에 따라 하고 싶은 직종과 할 수 있는 일자리 창출을 위한 기초자료로 활용될 것으로 기대된다.

• 예술인문사회 융합 멀티미디어 논문지
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• 제9권11호
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• pp.1015-1026
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• 2019

본 연구에서는 노인장기요양시설 평가지표개발과 관련된 선행연구의 평가현장 적용성 및 실효성이 미흡하다는 문제의식하에, 노인장기요양기관(시설급여) 평가의 품질향상을 위한 평가지표를 개발하는 데 연구의 목적이 있었다. 이를 위해 2018년도 노인장기요양기관(시설급여) 평가지표에 대한 분석적 고찰, 일본의 노인특별요양홈 평가지표에 대한 분석, 한국의 노인장기요양시설 종사자와 일본의 노인특별요양홈 종사자를 대상으로 한 평가지표 및 평가체계에 관한 FGI를 실시하였다. 연구결과를 토대로 하여 이용자가 양질의 서비스를 제공 받을 수 있도록 지원하는 측면에서 평가지표를 개발하였다. 노인의 특성, 즉 유지 및 호전되기 어려운 노인성 질환의 특성과 기관운영의 방향 및 투명성, 그리고 종말기 케어의 필요성 등을 반영하였다. 기관운영, 환경 및 안전, 수급자 권리보장, 급여제공과정, 급여제공결과를 포괄하는 43개의 평가지표를 제시하였다. 또한, 중복되고, 불필요한 평가과정을 개선하여 평가의 과정 효율성을 증가시킬 수 있는 4단계 다층평가시스템을 제안하였다.

• 한국산학기술학회논문지
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• 제17권5호
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• pp.452-458
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• 2016

본 논문은 노인요양시설 요양보호사들의 억제대 사용에 대한 인식을 조사한 서술적 조사연구이다. 자료수집은 2016년 1월 13일부터 2월 10일까지 노인요양시설 요양보호사 113명을 대상으로 자기기입식 설문을 통해 이루어졌다. 억제대 사용의 인식에 대한 전체 평균은 3.43(${\pm}0.24$)이였으며, 억제대 적용 이유로 가장 중요하게 생각하는 항목은 "대상자를 침대에서 떨어지지 않도록 보호하기 위하여"였으며, 주로 노인 대상자들의 안전사고를 예방하기 위한 항목에서 억제대 사용을 중요하게 생각하는 것으로 나타났다. 억제대 사용에 대한 지식은 18점 만점에 평균 11.23점으로 보통 수준이었으며, 50세 이하의 요양보호사들의 지식수준이 다소 낮았다. 억제대 사용에 대한 태도는 전체평균 9.19점으로 다소 긍정적으로 가급적 억제대 사용을 자제해야 한다고 생각했으며, 근무경력 3년 이하의 요양보호사들이 더 높게 나타났다. 억제대는 노인대상자의 신체 정신적 그리고 인권과 밀접한 관련이 있는 것으로 가장 많은 시간을 함께 하는 요양보호사들의 억제대 사용에 대한 인식의 고려와 향상을 위하여 억제대 사용에 대한 정확한 지침과 눈높이에 맞는 교육이 제공되어야 한다.

• 보건행정학회지
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• 제24권1호
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• pp.35-46
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• 2014

Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.

• 한국농촌간호학회지
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• 제2권1호
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• pp.24-32
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• 2007

Purpose: This study was done to provide statistical data for developing client-needs based welfare services in community welfare facilities. Method: The participants were 270 senior citizens, who visited a community welfare center in Gyunggi province, during the month of October 2005. They were asked to answer a structured questionnaire. Descriptive statistics, $X^2$ test and Fisher's exact test were used to analyze the data from 221 of the elders. Results: 1. More than 50% of the respondents were women aged between 60 and 75, who had education levels above high school and who lived in apartments. Among the respondents, 54.3% lived separately from their children. 2. 70.0% of the respondents considered their health status as "good", even though they had more than one disease. Also 41% of the respondents were supported by their children, and 76.8% wanted jobs. 3. The respondents pointed out several programs such as languages, computer, singing class, physical activities (dances, billiards, Tai-chi and table tennis), needed to be included in the welfare center programs. Conclusions: Elders aged 60-75, educated above high school, living in an apartments, live alone or with spouse, and having frequent contact with children, were the most frequent utilizers of the welfare center. They want the welfare center programs in variety, including languages, computer, singing class, and physical activities.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.311-329
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• 1996

This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

• 한국간호교육학회지
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• 제14권1호
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• pp.127-137
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• 2008

Purpose: This study aimed to explore the level of importance perceived by caregivers of elderly on the education of long term care nursing assistants (LTCNAs) taking care of elders with dementia or stroke. Method: Data was collected from 296 participants (112 families, 98 NAs, and 86 RNs) from October 2006 to February 2007. A structured questionnaire was used for data collection. Result: The item of 'attitude while caring for the aged' was identified as most important. The family group reported that 'position change' and 'understanding of geriatric diseases' were the most important for education, while LTCNAs, highly identified, 'bathing', and 'bed sheet change'. The RNs group regarded 'position change', and 'bathing' as most important. Institutions demanding LTCNAs' activities were special facilities for elderly care and special hospitals for the aged, and the need was also high in families with an elder incapacitated by illness. Conclusion: Nurses need to take an interest in education for enhancing the quality of LTCNAs and thus advance the quality of nursing care as well as the quality of life for the aged.